Review of discretionary medical cards halted, say Alex White

New card system to be developed on medical circumstances

The review of discretionary medical cards has been halted, Minister of State for Health Alex White has told the Dáil, while a new system based on medical need is developed.

In a policy change following the long-running controversy about discretionary cards, Mr White said the Cabinet committee on health met yesterday morning on the issue. “The HSE director general will now suspend reviews of medical cards where discretion has been exercised to take account of medical circumstances.”

The Cabinet committee has decided to “develop the policy framework governing eligibility in a manner that will also take account of medical conditions”.

Geographical variation

The discretionary medical card held by 150,000 people is currently based on financial means. Mr White said there was a significant geographical variation in the issuing of the cards, such as in Cork where 24 cards per 1,000 people were issued while it was four per 1,000 in Co Meath.

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The Minister said the HSE would establish an expert panel to examine the conditions that should be brought into consideration. This process would include the development of legislation as necessary.

He told TDs the Department of Health would develop a policy paper and there would be a further roll-out of GP care free at the point of access in the move to universal health insurance.

Mr White was speaking at the end of the second or introductory stage of the Health (General Practitioners Service) Bill to provide free GP care to children under six years of age.

He reiterated the under-six scheme, for which €37 million in funding has been earmarked, was part of the introduction of a universal free GP service “within its term of office”.

During debate on the legislation Independent TD Catherine Murphy highlighted the case of constituents, a family with four children, who succeeded in getting a medical card that was valid for three years but was told nine months later it was up for review. “The youngest child will qualify for a medical card but the person in the household who needs it most, who is six years old and has cerebral palsy, will not.”

Apologise

Independent TD

Denis Naughten

said yesterday morning a local GP phoned him to apologise “for the number of patients he has been referring to my office regarding medical cards”.

The doctor highlighted the volume of people who had had the card withdrawn, and he was “trying to put the paperwork in place to justify the reinstatement of that medical card for people who are critically ill or have chronic diseases”.

Mr Naughten said the whole idea of the discretionary card was to “address undue hardship”. But “the hardship is now being caused when applying for or trying to renew a medical card, or trying to appeal a decision which was wrong in the first place”.

Independent Finian McGrath said Department of Justice inquiries would cost about €2 million, but a playschool in Darndale, Dublin, which catered for 260 children, had a shortfall of €200,000.

“There seems to be money available for many other projects, but sometimes when it comes to children’s issues they are parked, and we have to kick and scream and jump up and down about them.”

People Before Profit TD Richard Boyd Barrett said the perception was that "we are giving free GP care to the under-sixes at the expense of other groups of chronically ill, disabled, elderly people and so on with serious medical needs" and this was unacceptable.

Marie O'Halloran

Marie O'Halloran

Marie O'Halloran is Parliamentary Correspondent of The Irish Times